Clinical observation of exenatide for treatment of obesity type 2 diabetes mellitus complicated with obstructive sleep apnea hypopnea syndrome / 新乡医学院学报

ABSTRACT

Objective To observe the clinical effect of exenatide for treatment of obesity type 2 diabetes mellitus (T2DM) conplicated with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Eighty patients of obesity T2DM complicated with OSAHS in the Department of Endocrinology,the First People's Hospital of Xinxiang from August 2014 to August 2016 were chosen and randomly divided into observation group(n =40) and control group(n =40).The patients in control group taken orally mefformin 800 mg twice daily for 24 weeks;based on this,the patients in observation group were injected subcutaneously exenatide 10 μg at one hour before meal,twice daily for 24 weeks.The fasting blood glucose (FBG),2-hour postprandial blood glucose (2 hPBG),glycosylated hemoglobin (HbA1 C),body mass index (BMI),waistline,total cholesterol (TC),triglyceride (TG),apnea hypoventilation index (AHI),Epworth sleepiness scale (ESS) score,the lowest oxygen saturation in sleep (LSpO2) were compared between the two groups before and after treatment.Results There was no statistic difference in the HbA1 C,FPG,2 hPBG levels of patients between the two groups before treatment (P ＞ 0.05);the HbA1 C,FPG,2 hPBG levels of patients in the two groups after treatment were significantly lower than those before treatment (P ＜ 0.05);and the HbA1 C,FPG,2 hPBG levels of patients in observation group were significantly lower than those in the control group after treatment(P ＜ 0.05).There was no statistic difference in the BMI,waistline and TC,TG levels of patients between the two groups before treatment(P ＞ 0.05);the BMI,waistline and TC,TG levels of patients in the two groups after treatment were significantly lower than those before treatment (P ＜ 0.05);and the BMI,waistline and TC,TG levels of patients in observation group were significantly lower than those in the control group after treatment(P ＜ 0.05).There was no statistic difference in the AHI,ESS scores,SpO2 and LSpO2 levels of patients between the two groups before treatment(P ＞0.05);the AHI,ESS scores,SpO2 and LSpO2 levels of patients in the two groups after treatment were significantly lower than those before treatment(P ＜0.05);and the AHI,ESS scores,SpO2 and LSPO2 levels of patients in observation group were significantly lower than those in the control group after treatment(P ＜0.05).The incidence of adverse reaction of patients in observation group and control group was 7.5％ (3/40) and 5.0％ (2/40) respectively;there was no statistic difference in the incidence of adverse reaction between the two groups (P ＞ 0.05).Conclusion Exenatide can effectively control blood glucose,improve the function of beta cells and reduce insulin resistance.It can effectively reduce body weight,BMI and waistline,improve the quality of sleep breathing.